Case study: community care & older people

Stage Two: Eight weeks later

Mhairi is still in hospital and - in spite of the initial fears of medical staff that she might not pull through - is now in a stable condition. The stroke, however, has left her with a marked speech impairment, making it difficult for anyone to understand her, and with pronounced physical impairment. At this stage it seems unlikely she will fully recover her mobility or speech and she is unlikely to be able to be discharged to the community for several weeks.

For the last four weeks Donald has been living temporarily in residential care. For the four weeks following Mhairi's hospital admission he received a complex package of domiciliary support. However, it soon became clear this was not sustainable. When they refused to buy him alcohol Donald argued aggressively with his home helps and occasionally tried to strike out at them. He wouldn't eat the meals provided - describing them as 'foreign muck' - and refused to go to bed, stating he was more comfortable sleeping in his chair. His personal hygiene habits resulted in some staff refusing to work with him.

Given the relatively remote location of his accommodation, it eventually proved impossible to find local staff willing to work with Donald. In spite of initial resistance Donald was eventually 'persuaded' to accept a place in a small, relatively nearby residential unit run by the local authority. However, his uncooperative and aggressive behaviour has led Maureen Phillip (the officer in charge) to call an urgent review with a view to finding Donald alternative accommodation.

Stage Two: Reflective questions

In relation to Donald:

Identify the various legal duties and powers open to the local authority in providing him with a package of domiciliary support and care.

What mechanism should be used to monitor the care provided to Donald and identify whether changes are needed?

On what basis would residential care be provided and what obligations, if any, would he have in terms of paying for his care?

If Donald persisted in refusing to live in residential care what powers would the local authority have to enforce this, if any?

What rights does Donald have to seek redress about concerns about any aspect of his care?

Identify the responsibilities the social work services agency has towards protecting its employees from abuse.